Bhide e professionalism.ppt resident talk revised 3 16
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Examples of social media use at Mayo Clinic, Mayo Clinic social media guidelines, hints for professional use of social media during residency
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Bhide e professionalism.ppt resident talk revised 3 16
- 1. Social Media and e-Professionalism for Residents Vandana Y. Bhide, MD www.VeeMD.com @VeeMD VeeMD #MayoClinicFL #HCSM #MedEd ©2010 MFMER | slide-1
- 2. • LA Dodgers outfielder Jayson Werth--left wrist fracture during spring training •Out for two months; after one year had surgery by hand specialist--pain and disability even worse Mayo Clinic Social Media Case Study
- 3. •“Baseball’s over, I’m going to be looking for a job, and I’ve done nothing but play baseball my whole life.” •Jayson sees Richard Berger,MD,PhD at Mayo Clinic
- 4. Ulnotriquetral Ligament • Dr. Berger and orthopedic surgeons at Mayo Clinic were first to describe a “mysterious” condition • Partial lengthwise tear of the UT ligament causes pain and weakness, but still holds bones in alignment ©2010 MFMER | slide-4
- 5. Dr. Berger’s Fovea sign—applying pressure on ulnar fovea reproduces patient’s pain ©2010 MFMER | slide-5
- 6. •Next day Jayson undergoes minimally invasive surgery for repair of partial tear of the UT ligament
- 7. ©2010 MFMER | slide-7 •Jayson goes on to win World Series with the Phillies
- 8. ©2010 MFMER | slide-8 •Werth signs 7-year/ $126 million contract with the Washington Nationals •Credits Dr. Berger with saving his career
- 9. • Mayo Clinic records a series of interviews with Jayson Werth on inexpensive flip camera • Posted on YouTube & Sharing Mayo Clinic Blog
- 10. Dr. Berger makes series of YouTube videos #Wristpain Twitter Chat
- 12. ©2010 MFMER | slide-12
- 13. Mayo Clinic “Know your Numbers” Short Version
- 14. What would you think if you saw this picture on Facebook and realized he was your doctor? Collier, Roger Professionalism: Social Media Mishaps CMAJ, September 4, 2012, 184(12)
- 15. Should physicians be held to a higher standard than the general public? What do you think?
- 16. Physicians are held to a higher standard, because of the trust placed on them by patients and society
- 17. Physicians—Private Lives or Public Citizens? • Physicians have the right to private live • Patients and the public see them as professionals rather than private individuals • View physician conduct through the lens of their expectations about how an esteemed member of the community should behave ©2010 MFMER | slide-20
- 18. Kesselheim, Jennifer et.al. for Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network (APPD LEARN) Study Group on Social Media and Professionalism. A National Survey of Pediatric Residents' Professionalism and Social Networking: Implications for Curriculum Development. Acad Pediatr. 2016 Mar;16(2):110-4. • 45% pediatric residents- inappropriate behavior on social media is “somewhat” or “very” prevalent • 53% were “somewhat” or “very” concerned that these behaviors may become more common • 42% reported observing trainees posting inappropriate comments about themselves 1- 4 times during the last year • 44% reported that they observed trainees posting inappropriate comments about their workplace 1- 4 times in the past year ©2010 MFMER | slide-21
- 19. Federation of State Medical Boards • Protect the Privacy and Confidentiality of their patients • Avoid requests for online medical advice • Act with professionalism • Be forthcoming about employment, credentials and conflicts of interest • Be aware that information posted online may be available to anyone, and could be misconstrued Rhyne JA et al Federation of State Medical Boards Model Policy Guidelines for the Appropriate Use of Social Media and Social Networking in Medical Practice www.fsmb.org
- 20. Federation of State Medical Boards • Protect the Privacy and Confidentiality of their patients Rhyne JA et al Federation of State Medical Boards Model Policy Guidelines for the Appropriate Use of Social Media and Social Networking in Medical Practice www.fsmb.org
- 21. "Physicians should be cognizant of standards of patient privacy and confidentiality that must be maintained in all environments, including online, and must refrain from posting identifiable patient information online.” AMA Policy: Professionalism in the Use of Social Media (June 2011)
- 22. “Blatant violations of patient privacy and confidentiality have occurred when physicians have described situations with enough identifying information that others may decipher the patient’s identify. http://www.ama-assn.org/resources/doc/code- medical-ethics/9124a.pdf
- 23. Physician Obligations—Same in person & online • Privacy—to prevent unauthorized access to patient data and to ensure that “de-identified” data cannot be linked to the healthcare professional or patient Rhyne JA et al Federation of State Medical Boards Model Policy Guidelines for the Appropriate Use of Social Media and Social Networking in Medical Practice www.fsmb.org • The Online Conversation is the same as the conversation in the Elevator or Hallway
- 24. ER Doc Violated Patient Privacy • Dr. A.T., who worked at Westerly Hospital, “did not include the patient’s name [in Facebook], but she wrote enough that others in the community could identify the patient” (Boston Globe). • An “unauthorized third party” determined the identity of the patient • Dr. A.T. deleted post and her Facebook account, apologized • Fired from position as ER physician, fined $500 Westerly, Rhode Island
- 25. ImpactedNurse.com “I published a de-identified image of an ‘interesting’ skull x-ray on my Facebook page, (in fact there was absolutely no information attached to this image, and even I had no idea who it belonged to, or what the clinical story behind it was). Incredibly…this x-ray was in fact correctly identified by a reader, who made an official complaint. The resulting disciplinary action brought my whole website/ Facebook presence to an uncomfortable, and personally distressing head”
- 26. http://www.ama- assn.org/resources/doc/code-medical- ethics/9124a.pdf “It seems that many of these violations take place because the Internet is widely perceived to be different from other public environments, like hospital corridors.”
- 27. • Need to get consent for Photography • Ask Mayo Photographer to take photo • No Cell phone pictures • Don’t let patients email you their photographs • Wounds • Cellulitis borders
- 28. • Don’t discuss patients (even if de-identified) on social media platforms • Don’t discuss aspects of your professional life (how many central lines you placed, how many admissions you had, how hard you had to work, how many times you were paged, how grateful a patient was for your care, etc.)
- 29. Federation of State Medical Boards • Avoid requests for online medical advice Rhyne JA et al Federation of State Medical Boards Model Policy Guidelines for the Appropriate Use of Social Media and Social Networking in Medical Practice www.fsmb.org
- 30. • Make sure that you differentiate medical opinions from medical facts. The world of medicine is foreign to many, so readers may take your words at face value. Try to make clear what statements reflect your personal beliefs University of Utah Health Sciences Center: Office of Graduate Medical Education Social Media Policy December 3, 2012
- 31. • Act with professionalism Rhyne JA et al Federation of State Medical Boards Model Policy Guidelines for the Appropriate Use of Social Media and Social Networking in Medical Practice www.fsmb.org
- 32. Photographs depicting alcohol ©2010 MFMER | slide-35 • Ryan Greysen, Assistant Professor Hospital Internal Medicine UCSF (R), staged a hypothetical picture depicting alcohol without intoxication • According to a survey of State Medical Boards, this type of online physician behavior could potentially prompt investigation of physician professionalism
- 33. Photographs depicting alcohol: •It is better to avoid all pictures and mentions of drinking •Even when done on personal time away from Mayo Clinic •Even when “drinking responsibly”
- 34. ©2010 MFMER | slide-37
- 35. • Facebook Groups: Community • Tags: Partying doctors Haiti ©2010 MFMER | slide-38
- 36. ©2010 MFMER | slide-39 Haiti earthquake relief physician volunteers
- 37. ©2010 MFMER | slide-40 Smiling before an amputation
- 38. • The internet is like Vegas: What happens there stays there… • Forever • You can take it down but you can’t take it back
- 39. Physicians must recognize that actions online and content posted may negatively affect their reputations among patients and colleagues, may have consequences for their medical careers (particularly for physicians- in-training and medical students) AMA Policy: Professionalism in the Use of Social Media
- 40. • Everything residents post online contributes to a lifetime record that is readily accessible to others. • Potential employers may use social media to evaluate applicants. • Posting distasteful, immature, or offensive content may eliminate job or other professional opportunities. • Residents must convey a professional and ethical presence to all who might view their online University of Utah Health Sciences Center: Office of Graduate Medical Education Social Media Policy December 3, 2012
- 41. http://www.ama- assn.org/resources/doc/code-medical- ethics/9124a.pdf Something as seemingly innocuous as humor, when taken out of context, could reach and be misinterpreted by an unintended audience (patients, superiors, future employers) and lead to a tarnished reputation
- 42. • If they interact with patients on the Internet, physicians must maintain appropriate boundaries of the patient-physician relationship • Physicians should consider separating personal and professional content online AMA Policy: Professionalism in the Use of Social Media ©2010 MFER | slide-49
- 43. Use privacy settings to safeguard personal information and content to the fullest extent possible on social networking sites AMA Policy: Professionalism in the Use of Social Media ©2010 MFMER | slide-50
- 44. Mayo Clinic Social Media Policy • Strongly discourages “friending” of patients on social media websites • Does not endorse people, products, services and organizations. http://sharing.mayoclinic.org/guidelines/for-mayo-clinic-employees/
- 45. Mayo Clinic Social Media Policy • On social media websites such as LinkedIn, where affiliation to Mayo Clinic is known, personal recommendations should not be given or requested • Write in the first person…make it clear that you are speaking for yourself and not on behalf of Mayo Clinic http://sharing.mayoclinic.org/guidelines/for-mayo-clinic-employees/
- 46. #SocialAtMayo - Mayo Clinic's Social Media Guidelines https://youtu.be/pjocDhlicJs
- 47. Questions?
- 48. Social Media and e-Professionalism for Residents Vandana Y. Bhide, MD Vitamin Vee Blog www.VeeMD.com @VeeMD VeeMD Channel Vandana Bhide #MayoClinicFL #HCSM #MedEd
Editor's Notes
- Right Fielder, Dodgers, Phillies, Nationals Avulsion fx diagnosed
- When I saw Jayson, it was literally only five minutes into the appointment that I made the diagnosis based on this area of tenderness," Berger says. With a UT split tear, a long tear runs lengthwise along the ligament, making wrist rotation painful, Berger says. A patient's history and an MRI confirm the injury, but the damage may not be clearly visible on an MRI, especially if you aren't looking for it, he says.
- When I saw Jayson, it was literally only five minutes into the appointment that I made the diagnosis based on this area of tenderness," Berger says. With a UT split tear, a long tear runs lengthwise along the ligament, making wrist rotation painful, Berger says. A patient's history and an MRI confirm the injury, but the damage may not be clearly visible on an MRI, especially if you aren't looking for it, he says.
- 5/12 repair displaced left distal radius fracture by Dr. Berger
- Werth 3 videos
- Jayson Werth #28 of the Washington Nationals looks on before taking on the St. Louis Cardinals in Game Five of the National League Division Series at Nationals Park on October 12, 2012 in Washington, DC. Dr. Berger is conducting an ongoing conversation about this type of injury on Twitter using the #wristpain hash tag, so you can ask questions by including #wristpain in your tweet, or in the comments on this post.
- Berger has played an integral part in nursing Werth’s left wrist back into shape. After Werth was first hit in the left wrist by a pitch in 2005, tore a ligament, dealt with months of pain, missed a year and had a surgery that didn’t solve the problem, Berger diagnosed the trouble and performed surgery to fix it in 2006. Berger inserted screws and a plate into Werth’s wrist when he broke it in 2012 diving for a ball in right field. After discomfort persisted in Werth’s wrist following his hit-by-pitch earlier this month, he went to see Berger. Two weeks ago, the initial x-ray in San Diego the night Werth was hit by a a 92 mph fastball from Padres starter Odrisamer Despaigne came back negative. (Imagine how much worse Werth’s injury could have been if he hadn’t been wearing a wrist guard.) A MRI exam four days later in Washington with the Nationals medical staff showed no broken bones or ligament tears. But Werth continued to experience swelling and soreness, which prevented him from rotating the wrist and swinging a bat.
- The streaking Washington Nationals were dealt a blow Thursday when a CT scan, essentially a higher-quality exam, of Jayson Werth’s ailing left wrist revealed two small fractures, according to a person familiar with the situation. Werth’s wrist, which hasn’t improved enough since it was hit by a pitch May 15, will be immobilized for four weeks. The hope is that the 36-year-old veteran left fielder, after rehabilitation, could be back with the Nationals as soon as August. Werth was examined Thursday by Richard Berger, a wrist specialist, of the Mayo Clinic in Rochester, Minn. Over the years, Berger has treated Werth’s left wrist, which has been a magnet for pitches and frustrating injuries, including one that threatened his career earlier.
- 6/15 BUENOS AIRES, Argentina -- Former US Open champion Juan Martin del Potro underwent surgery on his left wrist Tuesday, just days after he pulled out of the Australian Open. Del Potro had the surgery at the Mayo Clinic in Rochester, Minnesota, and said on his Facebook page that he did so at the recommendation of his physician. The surgery was done by Dr. Richard Berger, who operated on del Potro's same wrist 10 months ago. He also performed surgery on the Argentine's right wrist in 2010, the year after he won the US Open. Del Potro's management said in a statement that the Argentine would resume training in two weeks. It did not say when he might play again.
- KevinMD.com is the web’s leading social media health platform, with 1 million monthly page views, and over 100,000 subscribers on Facebook, Twitter, LinkedIn, and RSS.
- 973,911,580 people worldwide are Facebook users, 168,800,560 users in the US
- <iframe width="560" height="315" src="https://www.youtube.com/embed/AdZTAzJsmPg" frameborder="0" allowfullscreen></iframe>
- Moral: once on the internet content is likely there permanently
- How tired you are
- One of the survey’s 10 hypothetical vignettes of social media posed to medical board executives shows a photo of three doctors, drinks in hand, at a hospital holiday party. Forty percent of executives said a complaint to the board about the posting would trigger an investigation — a “low consensus” among survey respondents. But 73% took issue with a vignette of a doctor who posted photos of himself intoxicated.
- One of the survey’s 10 hypothetical vignettes of social media posed to medical board executives shows a photo of three doctors, drinks in hand, at a hospital holiday party. Forty percent of executives said a complaint to the board about the posting would trigger an investigation — a “low consensus” among survey respondents. But 73% took issue with a vignette of a doctor who posted photos of himself intoxicated.
- “When you post something publicly online, it’s something that could be online in perpetuity” Humayan Chaudry, DO, President and CEO of the Federation of State Medical Boards
- It is advisable that you set your privacy profile so that only those people whom you provide access may see your personal information and photos